According to the anatomy characteristics of vertebral pedicle and on the basis of puncture site on the skin to the level distance of vertebral process, a three-dimension guider was designed. Eighty-three cases were received percutaneous vertebroplasty from December 2006 to December 2008, including 43 cases with three-dimension guider. Thirty-six cases of above 43 cases puncture site were guided by fluoroscopy, and then performed percutaneous vertebroplasty by three-dimension guider without fluoroscopy monitoring under guidance of preoperative CT measures. The rest 7 cases of 43 were performed percutaneous vertebroplasty by the monitored by fluoroscopy. All cases were successful, and the needle tip could reach the ideal position. Forty cases were received primary two-dimesion guider to perform the percutaneous vertebroplasty, which were monitored by fluoroscopy. The mean puncture time was 1.9 minutes in two-dimension guider while 1.5 minutes in three-dimension guider. Results demonstrated that three-dimension guider has the virtue of logical design, suit for the body anatomy and easy to perform, which can reduce the expose time of x-rays and more safety and efficiency to operators.

Objective The purpose was to explore the preventive measures of patellar baja following high tibial osteotomy for osteoarthritis, and the correlation between alteration in the inclination of the proximal tibial articular surface and patellar baja was evaluated as well. Methods In the group, there were 41 cases (48 knees), which included 30 males and 11 females, aging from 45 to 56 years with the mean age of 52 years. The size of resected bone of the arthritic knee needed to achieve a normal angle was calculated, and an additional 3 to 5 degrees of overcorrection was added to achieve approximately 10 degrees of genu valgum. The Insall-Salvati ratio, the inclination of the proximal tibial articular surface, the tibial tubercle height and the anatomic axis of the affected limbs were measured on the preoperative, postoperative as well as the final follow-up radiographs respectively. Chi-square test and linear regression analysis were used to assess the influence of loss of proximal tibial articular inclination on the patellar height. In the statistical analysis, loss more than 5 degrees of proximal tibial articular inclination and lowering more than 10% of the patella following tibial osteotomy were assumed of clinical significance. Results Compared with the preoperative results, the postoperative inclination of the proximal tibial articular surface was decreased by a mean of 6.14 degrees; the postoperative Insall-Salvati ratio was decreased by a mean of 10.6%; the postoperative height of the tibial tubercle was decreased by a mean of 3.13 mm. 64.6% (31/48 knees) endured loss more than 5 degrees of posterior tibial inclination after high tibial osteotomy, whereas 56.2% (28/48 knees) showed a relative lowering of patellar height more than 10%, as measured by the Insall-Salvati ratio. The loss of the normal posterior tibial inclination was found to have a statistically significant correlation with the subsequent loss of the patellar height. Conclusion The loss of inclination of the proximal tibial articular surface is found to have a correlation with the loss of the patellar height. Clinically, the result suggests that preserving the inclination of the proximal tibial articular surface at the time of high tibial osteotomy could minimize the risk of patellar lowering after the high tibial osteotomy.

Objective To evaluate the clinical results from the treatment of local chondral or osteochondral lesions on the talus dome with autologous osteochondral transplantation or mosaicplasty harvested from the ipsilateral knee. Methods There were 23 patients with chondral defects of the talus dome including post-traumatic cartilage defects(n=11), osteochondritis dissecans(n=9), and local osteoarthritis(n=3). The position and size of the defect were defined under ankle arthroscopy. The procedures consisted of debriding its edges and base drilled under ankle arthroscopy or arthrotomy, then harvesting osteochondral cylinders from non-weight bearing surface of the ipsilateral knee under arthroscopy, and using the osteochondral autograft transfer system(OATS) to implant the donor graft into the recipient holes of talus cartilaginous defects with press-fit technique. A single donor transplantation or the mosaicplasty was used. Results All the patients were followed up for 15 to 30 months(mean, 22 months). The mean pain intensity measured by standard visual analogue scale(VAS) reduced from 4.9?1.2 to 0.8?0.1 at final follow-up(P

Objective To analyze the risk factors for thrombosis by investigating the incidence of central venous catheter‐related thrombosis in elderly patients .Methods Four hundred and five elderly patients who underwent central venous catheterization were divided into femoral vein group(n=46) ,internal jugular vein group (n=40) and subclavian vein group (n=319) according to their catheter position ,or into thrombosis group (n=31) and non‐thrombosis group (n=374) according to the incidence of central venous catheter‐related thrombosis .T heir gender ,age ,basic diseases ,catheter position ,retention time of catheter ,and complications of central venous catheter‐related thrombosis were retrospectively analyzed .Results The incidence of central venous cathe‐ter‐related thrombosis was significantly lower in subclavian vein group than in internal jugular vein group and femoral vein group (5 .0% vs 15 .0% ,5 .0% vs 19 .6% ,P<0 .05 ,P<0 .01) .The percentage of past venous thrombosis history was significantly higher in thrombosis group than in non‐thrombosis group (19 .4% vs 6 .4% ,P<0 .05) .Conclusions Subclavian vein catheterization can significantly reduce the incidence of central venous catheter‐related thrombosis and past ve‐nous thrombosis history can predict the incidence of central venous catheter‐related thrombosis in elderly patients .

[Objective]To evaluate efficacy and method of arthroscopic meniscoplasty for horizontal tear of discoid lateral meniscus in a short follow-up term. [Method]A series of 27 patients (27 knees) (mean age 32 years, range 6 years to 42 years) who underwent arthroscopic evaluation and treatment of a discoid lateral meniscus between 2002 and 2006 was reviewed. All the patients who were selected had the horizontal type of tear. Of those discoid menisci classified intraoperatively (n=27), 85.2% (n=23) were complete discoid lateral menisci and 14.2% (n=4) were incomplete discoid lateral menisci. No Wrisberg type was noted. Arthroscopic meniscoplasty was performed in all cases. The horizontal tear meant meniscus was divided into two leaves. The auther removed the unstable leaf to the peripheral rim and preserved the stable one. Arthroscopic meniscoplasty was performed in the stable leaf.[Result]All the patients were evaluated at follow-up according to the Lysholm knee Scoring Scale. At follow-up, patients were reviewed to recognize possible of retear and requirement of arthroscopic revision. The knee score of these patients improved from 72.48?4.64 points preoperatively to 92.18?4.52 points postoperatively. Recurrence of tear or requirement of arthroscopic revision was not noted at the final follow-up. [Conclusion]Arthroscopic meniscoplasty of the horizontal tear of discoid meniscus is an effective method.

[Objective]To determine the efficacy and characteristics of percutaneous vertebroplasty in treating patients with vertebral osteoporosis fractures combined with intraosseous cyst.[Method]Thirteen cases of vertebral osteoporosis fractures combined with intraosseous cyst were performed with percutaneous vertebroplasty.Bone cement containing appropriate proportion allograft bone powder were injected to vertebral body according to the sererity of osteoporosis and the size of intraosseous cyst.[Result]According to standard of World Health Organization about pain,complete pain relief was in 10,partial in 2,and slight in 1 patient.One case developed bone cement leakage into the paravertebral soft tissues during operation,but there were no clinical signs and symptoms.The next vertebral body fracture was found at sixteen days after percutaneous vertebroplasty in 1 case,and percutaneous vertebroplasty was repeated to relieve his pain.This patient was followed-up for 1 year,and no refracture was observed.[Conclusion]Vertebral osteoporosis fractures combined with intraosseous cyst is a special disease in elderly population.Percutaneous vertebroplasty is effective and it shouled be the first option for treatment of patients with vertebral osteoporosis fractures combined with intraosseous cyst.The complications could be reduced by local treatment combined with anti-osteoporosis drugs and correct rehabilitation.

Objective To explore optimal puncture route and method for advance pierce accuracy when perform percutaneous vertebroplasty. Methods 248 cases (365 vertebrae )with osteoporotic vertebral body fractures in thoracic vertebral and lumbar vertebral were treated by percutaneous vertebroplasty. Total injured vertebraes were examined and measured puncture routes under CT before operation. Then according to measure route pierce and perform percutaneous vertebroplasty, when the pricker arrived preconceive place, take some radiographs obverse and side, after operation,scan injured vertebraes with CT again. Pierce accuracy was evaluated. Results 365 vertebrae were pierced successfully,the pierce successful rate was 100%. 324 vertebra piercing route were coincident with CT measure routes,coincident rate 88.8%. 41 vertebra piercing route weren' t coincident with CT measure routes, deflective rate was 11.2%. Conclusion CT measure puncture route and directing pierce was effective means when percutaneous vertebroplasty.

Objective To detect the expression of EGF mRNA in renal parenchyma in congenital hydronephrosis in children and to evaluate the role of EGF in causing chronic renal damage. Methods The expression of EGF mRNA in renal parenchyma, renal pelvis and PUJ tissues from congenital hydronephrosis in children was studied by means of RT PCR. Results The expression of EGF in the aff ected renal parenchyma and PUJ tissues decreased.It also decreased in the affected pelvis but the difference was not significant. The decrease of EGF expression was the most obvious in the affected renal parenchyma. Conclusions EGF expression decreased in renal parenchyma in congenital hydronephrosis and the decrease might be related to the chronic renal damage and renal atrophy caused by hydronephrosis.

0.05). But when the flexion exceeded 30?, especially when it exceeded 60?, the displacement in pPc increased markedly, much greater than that of an intact knee (P0.05), while a slight over-restriction may be found at some angles. Conclusion Double-band reconstruction could effectively restrict the posterior displacement of the tibia and restore anteroposterior stability to the knee joint within its full range of flexion. aPc reconstruction could also maintain the posterior stability of the knee, while the result of pPc reconstruction is most unsatisfactory.

Objective To evaluate the possibility for the treatment of chondral defects on the femoral bearing surface with autologous osteochondral transplantation under arthroscopy. Methods There were 17 patients with cartilaginous surface defects, including 12 males and 5 females. The average age of patients was 29 years ranging from 18 to 45 years. The defects were located at 10 left knees and 7 right knees. The functional status of patients were evaluated according to the Brittberg-Peterson scoring scale system, the results were average 80.65?9.69 points ranging from 65 to 105. 3 patients had no an obvious history of trauma, but suffered from the rheumatoid disease; however, the other 14 patients had been injured at the knee joint with pain and followed with muscle atrophy on the thigh. 3 patients experienced interlocking, and 2 had snapping in their knee joints. All the 14 patients with traumatic history had only solitary lesion, the area of local cartilaginous defects at the bearing surface of the lateral femoral condyle was of 2.5-3.0 cm2; the local defects of the other 3 patients were located at the medial femoral condyle with defect area of 2.0-2.5 cm2, which was diagnosed either as chondomalacia or corruption. The procedures of the mosaicoplasty consisted of harvesting osteochondral cylinders from non-weight bearing surface of the knee and then implanting the grafts into the cartilaginous defects under arthroscopy. Results All the patients were followed up for 10 to 20 months (mean, 15 months). The joint mobility recovered to nearly normal. According to the Brittberg-Peterson system, 14 patients had score of 0, and 3 had scores of 2-3 because of mild pain. The follow-up MRI showed adequate cartilaginous coverage in the original lesions and excellent position of the cylindrical osteochondral grafts. Conclusion The autologous osteochondral mosaicplasty is proved to have good and reliable clinical results for the cartilaginous defects in the knee bearing surface.